The Efficacy of Tranexamic Acid for Reducing Blood Transfusion Rates in Extracapsular Hip Fractures: A Single-Center...

Area of Science:

• Orthopedic Surgery
• Trauma Care
• Pharmacology

Background:

• Perioperative blood transfusions in hip fracture patients increase costs and complications.
• Extracapsular hip fractures often involve significant blood loss, necessitating transfusions.

Purpose of the Study:

• To evaluate if tranexamic acid (TXA) reduces blood transfusion rates and blood loss in extracapsular hip fractures.
• To assess the efficacy of TXA administered intravenously upon hospital admission.

Main Methods:

• Prospective randomized controlled trial involving 100 patients with extracapsular hip fractures undergoing intramedullary nailing.
• Patients received either 1g intravenous TXA or normal saline upon hospital arrival.
• Outcomes included transfusion rates, blood loss, length of stay, and mortality.

Main Results:

• Postoperative transfusion rates were lower in the TXA group (17.5%) compared to placebo (36.7%), P=.046.
• Total blood loss was significantly reduced in the TXA group (mean difference, 367 mL), P=.01.
• No significant differences were observed in intraoperative blood loss, hospital stay, or 30-day mortality.

Conclusions:

• Single-dose intravenous TXA administered on hospital admission effectively decreases postoperative blood transfusion risk and perioperative blood loss in extracapsular hip fractures.
• TXA is recommended for intravenous administration upon admission for patients with extracapsular hip fractures.